Pregnant women should receive specialised
advice before travelling. The ideal time to
travel is in the second trimester (between 16
and 28 weeks), when the risk of pregnancy-
related problems are at their lowest and
pregnant women generally feel at their best.
During the first trimester there is a risk of
miscarriage and in the third trimester com-
plications such as premature labour and high
blood pressure are possible. It's wise to travel
with a companion. Always carry a list of qual-
ity medical facilities available at your destina-
tion and ensure you continue your standard
antenatal care at these facilities. Avoid rural
travel in areas with poor transportation and
medical facilities. Most of all, ensure travel
insurance covers all pregnancy-related pos-
sibilities, including premature labour.
Malaria is a high-risk disease in pregnancy.
The WHO recommends that pregnant women
do not travel to areas with Chloroquine-resistant
malaria. None of the more effective antimalar-
ial drugs are completely safe in pregnancy.
Traveller's diarrhoea can quickly lead to de-
hydration and result in inadequate blood flow
to the placenta. Many of the drugs used to treat
various diarrhoea bugs are not recommended in
pregnancy. Azithromycin is considered safe.
In the tourist areas of Bali, supplies of sani-
tary products and brands that are familiar are
readily available. On Lombok the major brand
sanitary towels are not a problem to get hold
of and are reasonably priced. Tampons, how-
ever, are like gold dust, they are hard to find
and super expensive! Try and bring you own
from home or stock up on them in Hero super-
market in Mataram or in the supermarkets in
Senggigi. Tampax and Lillets are available.
Birth-control options may be limited so
bring adequate supplies of your own form of
Heat, humidity and antibiotics can all con-
tribute to thrush. Treatments are antifungal
creams and pessaries such as Clotrimazole.
An alternative is a tablet of fluconazole (Dif-
lucan). Urinary tract infections can be precipi-
tated by dehydration or long journeys without
toilet stops; bring suitable antibiotics.
A number of parasites are transmitted via the
skin by walking barefoot including strongy-
loides, hookworm and cutaneous larva
Fungal rashes are common in humid climates.
There are two common fungal rashes that af-
fect travellers. The first occurs in moist areas
that get less air such as the groin, armpits and
between the toes. It starts as a red patch that
slowly spreads and is usually itchy. Treat-
ment involves keeping the skin dry, avoiding
chafing and using an antifungal cream such
as Clotrimazole or Lamisil. Tinea versicolor
is also common - this fungus causes small,
light-coloured patches, most commonly on
the back, chest and shoulders. Consult a
Cuts and scratches become easily infected
in humid climates. Take meticulous care of
any cuts and scratches to prevent complica-
tions such as abscesses. Immediately wash all
wounds in clean water and apply antiseptic. If
you develop signs of infection (increasing pain
and redness) see a doctor. Divers and surfers
should be particularly careful with coral cuts
as they become easily infected.
Southeast Asia is home to many species of both
poisonous and harmless snakes. Although you
are unlikely to run into snakes in Bali or on
Lombok (you may come across the black-and-
white stripy sea snakes on Lombok), assume all
snakes are poisonous and never touch one.
Even on a cloudy day sunburn can occur
rapidly. Always use a strong sunscreen (at
least factor 30), making sure to reapply after
a swim, and always wear a wide-brimmed hat
and sunglasses outdoors. Avoid lying in the
sun during the hottest part of the day (10am
to 2pm). If you become sunburnt stay out of
the sun until you have recovered, apply cool
compresses and take painkillers for the dis-
comfort. One per cent hydrocortisone cream
applied twice daily is also helpful.